[Hiring] Clinical Support Analyst @CVS Health

Role Description

The LTSS Operations Analyst supports LTSS leadership by managing operational reporting, monitoring case management assignments and caseloads, supporting timely State reporting, and providing data-driven insight to improve performance, compliance, and member outcomes. This role helps ensure work is completed accurately, timely, and in alignment with contractual and regulatory requirements.

Key Responsibilities

• Case Management Assignment & Caseload Management
  • Manage case management assignments from initial outreach through reassignment and monthly caseload rebalancing.
  • Monitor caseload distribution to support staffing alignment, workload balance, and contractual requirements.
  • Track assignment changes and ensure operational data remains accurate and current.
• State, Contractual & Operational Reporting
  • Prepare and support timely State-required reports with accurate, detailed information prior to submission.
  • Track performance against contractual, regulatory, and organizational requirements.
  • Validate data for accuracy, completeness, and reporting integrity.
• Data Analytics & Operational Monitoring
  • Develop and maintain reports, dashboards, scorecards, and tracking tools.
  • Monitor KPIs, identify trends, and provide leadership with actionable insights.
  • Analyze staffing, productivity, workload distribution, utilization activity, and provider-related impacts.
• Strategic & Process Improvement Support
  • Partner with LTSS leaders to identify process gaps, risks, and improvement opportunities.
  • Prepare executive summaries, presentations, and business review materials.
  • Support audits, accreditation activities, special projects, and regulatory readiness efforts.
• Collaboration & Communication
  • Collaborate with Case Management, Quality, Network, Compliance, Finance, and Provider Relations.
  • Communicate findings clearly and concisely to support timely operational action.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Data Analytics, or related field preferred.
• 2+ years of healthcare, managed care, business analytics, or operational analysis experience.
• Advanced proficiency in Microsoft Excel, required.
• Experience with Power BI, Tableau, QuickBase, SQL, or similar reporting tools preferred.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills, required.

Requirements

• Medicaid managed care experience.
• LTSS, case management, utilization management, or provider operations experience.
• Experience supporting executive reporting and performance improvement initiatives.
• Knowledge of healthcare quality metrics and regulatory requirements.

Benefits

• Comprehensive benefits package designed to support physical, emotional, and financial well-being.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.